Pulpitis is an inflammation of the inner tissue of a tooth. Bacteria that enter the tooth through a cavity or crack cause an infection. Early pulpitis is reversible. Without treatment, the inflammation will worsen and the nerve or tooth may need to be removed. Good dental hygiene and regular visits to the dentist can prevent pulpitis.
What is pulpitis?
A tooth has three layers: the enamel on the outside, the dentin that supports the enamel, and the pulp on the inside of the tooth. The pulp is the soft inner tissue of the teeth. It contains nerves, blood vessels and connective tissue. The pulp supplies blood and nutrients to the teeth to keep them healthy.
Pulpitis is an inflammation of the pulp. This usually happens when there is irritation inside the tooth due to bruxism or tooth decay.
What are the types of pulpitis?
There are two types of pulpitis. Dentists classify them depending on the degree of infection.
Reversible pulpitis: At this early stage, pulpitis is reversible if the dentist cures the tooth and fills it.
Irreversible pulpitis: at this stage, the inflammation progresses, and the tooth cannot be restored. Pulp tissue eventually dies and pulp necrosis occurs.
What are the symptoms of pulpitis
Toothache and increased sensitivity are the main symptoms of pulpitis. The pain you feel usually varies depending on the stage of the inflammation.
Symptoms of reversible pulpitis include:
- sharp pain;
- absence of pain when the dentist taps on the tooth;
- no sensitivity to heat;
- sensitivity to cold or sweet that quickly disappears.
Irreversible pulpitis may have the following symptoms:
- pain when the dentist knocks on the tooth;
- sensitivity to heat, cold, or sweet that lasts more than a few seconds;
- throbbing, aching or sharp pain;
- swelling around the tooth and gums;
- fever;
- bad breath;
- it is difficult to determine which tooth is causing the pain.
If pulp necrosis occurs and the nerve tissue dies, you may not have sensitivity to heat, cold, or sweet, but the tooth may still hurt when tapped. After that, the tooth can become infected and cause an abscess. Once this happens, it may appear that the infected tooth has become taller than the others.
What causes pulpitis?
Tooth enamel protects the pulp. If the enamel is damaged, it can lead to pulpitis.
Tooth damage can occur due to:
- Tooth decay: Bacteria in the mouth produce acid that can eat away at the enamel and create holes in the tooth.
- Cracks: Small cracks can occur if you chew hard food or injure your tooth.
- Dental procedures: dental treatment can cause pulpitis. If the tooth is improperly filled, it can lead to the development of secondary caries and cause pulpitis.
- Worn enamel: Grinding teeth or aggressive brushing can wear down the enamel and make the nerve more vulnerable to inflammation.
- Advanced periodontal disease: periodontitis is a serious gum disease caused by a bacterial infection. It usually starts with gum inflammation that is not properly treated. Periodontitis can cause bone loss, which can lead to pulpitis.
How is pulpitis diagnosed?
One of the main ways to diagnose pulpitis is to evaluate the reactions of the nerve tissues of the pulp.
- Electrodentoscopy: This test determines if the pulp is alive or if the infection has progressed to pulp necrosis.
- Testing reactions to heat and cold: in irreversible pulpitis, sensitivity persists for more than a few seconds. If the pulp tissue is dead, you will not feel any sensitivity.
- Tapping: pain when tapping is a sign of irreversible pulpitis.
- Dental X-rays to detect tooth defects and signs of infection.
How is pulpitis treated?
With reversible pulpitis, the dentist will try to eliminate the cause and preserve the pulp and the functionality of the tooth. This often involves treating caries and filling the tooth with a conventional filling.
Irreversible pulpitis requires removal of pulp tissue or tooth.
Antibiotics do not cure pulpitis, but they can help prevent the infection from progressing if treatment is delayed. However, the opinions of experts regarding the use of antibiotics for pulpitis differ. Some experts claim that pulpitis is not always caused by bacteria, so antibiotics should not be prescribed.
What are the possible complications of pulpitis?
If left untreated, pulpitis can lead to a periapical abscess, in which the infection is localized to the bone or soft tissue. A person may notice the accumulation of pus near the tooth.
Symptoms may include:
- swelling of glands and lymph nodes;
- fever;
- chills;
- difficulty swallowing or difficulty opening the mouth.
If a person experiences any of the above symptoms, they should seek emergency medical attention.
The process can spread to the jaw bone (osteomyelitis) and soft tissues of the head, neck and chest. If left untreated, these infections can be life-threatening.
How to prevent pulpitis?
Good oral hygiene is the best way to prevent pulpitis.
To prevent the disease, it is necessary:
- brush your teeth twice a day;
- use dental floss;
- visit a dentist for scheduled cleanings and examinations;
- wear a mouth guard if you grind your teeth at night.
Also, be sure to see your dentist right away if your tooth hurts or has severe sensitivity.